LEARN · MEDICATION
Medication during pregnancy and postpartum
Deciding whether to take medication while pregnant or breastfeeding can feel overwhelming, especially with so much conflicting information out there. Here's what the research says, so you can make an informed choice with your prescriber.
THE BASICS
Your options
01 — FIRST-LINE TREATMENT
SSRIs
Selective serotonin reuptake inhibitors (SSRIs), such as sertraline (Zoloft) and escitalopram (Lexapro), are the first-line medication for depression and anxiety during pregnancy and postpartum. They are among the most studied medications in pregnancy.
Many people start to feel better within a few weeks, with fuller benefit by about 6 to 8 weeks.
02 — MADE FOR POSTPARTUM DEPRESSION
Zuranolone (Zurzuvae)
In 2023, the FDA approved zuranolone as the first pill made specifically for postpartum depression. It is taken once a day in the evening for 14 days, and it can start working within days rather than weeks.
It causes drowsiness, so you can't drive for at least 12 hours after each dose. Research on breastfeeding is still limited, so talk with your prescriber about your feeding plans.
03 — WHO PRESCRIBES
Your OB/GYN, primary care provider or psychiatrist
Many OB/GYNs and primary care providers prescribe medication for depression and anxiety during pregnancy and postpartum. For more complex situations, a reproductive or perinatal psychiatrist can help.
As a psychologist, I don't prescribe medication. With your permission, I coordinate with your prescriber so your care works together.
SAFETY · SEPARATING FACT FROM FEAR
Is it safe during pregnancy and breastfeeding?
There is a lot of misinformation about medication during pregnancy and breastfeeding, and some 2025 headlines questioned whether SSRIs are safe in pregnancy. Leading medical groups, including the American College of Obstetricians and Gynecologists (ACOG), continue to support SSRIs as a safe and appropriate option for many women.
What the research shows
SSRIs are among the best-studied medications in pregnancy, and most studies don't show a meaningful increase in birth defects.
Only small amounts pass into breast milk, and many SSRIs, especially sertraline, are considered compatible with breastfeeding.
Some newborns are a little jittery or fussy after exposure late in pregnancy. This is usually mild and passes within days.
Don't stop a medication suddenly when you find out you're pregnant. Stopping raises the risk of relapse, so talk with your prescriber first.
For questions about a specific medication, MotherToBaby and LactMed share free, evidence-based information.
THE OTHER SIDE OF THE SCALE
Untreated depression has risks too
Choosing not to take medication isn't a risk-free choice. Research links untreated depression and anxiety in pregnancy and postpartum to:
Preterm birth and low birth weight
Preeclampsia
Missed prenatal care and more substance use
Challenges with bonding, feeding and the baby's development
Relapse and, in the most serious cases, self-harm
Weighing it together
For many women, the risks of untreated depression to them and their baby outweigh the risks of medication. The right choice depends on your symptoms, history and preferences, and it's yours to make with your prescriber.
Therapy is effective on its own for many women and works well alongside medication.
DISCUSSION POINTS
Questions to bring to your appointment
Write your questions down ahead of time, and consider bringing a partner or support person.
Would medication help me, given my symptoms and history?
What are the benefits and risks of this medication during pregnancy or breastfeeding?
What are the risks of not treating my depression or anxiety?
How soon might I notice a difference, and what side effects should I watch for?
What dose will we start with, and how will we adjust it?
How long will I take it, and how will we decide when to stop?
What should I do if I become pregnant, or after the baby arrives?
Who do I call if I have questions or feel worse between visits?
RESOURCES
Trusted information
MotherToBaby
Free, evidence-based answers about medications in pregnancy and breastfeeding, by phone, text, chat or email.
LactMed
A National Library of Medicine database on medications and breastfeeding.
PSI HelpLine
Call 1-800-944-4773 for support and help finding perinatal mental health care, including prescribers.
This page is for general education and isn't medical advice. Never start, stop or change a medication without talking to your prescriber. If you're worried about your safety, call or text 988, or call 911.
Have questions about medication and therapy?
We can talk through your options and, with your permission, coordinate with your prescriber.